Pathollogically, a large duct papilloma is a benign proliferation of duct epithelium that projects in to the
lumen of the duct. The papillary fronds are composed of a fibrovascular core covered by ductal epithelial
and myoepithelial cells (1,2, 5). Papillomas are usually located within a major duct in the subareolar region.
Multiple peripheral papillomas are associated with an increased risk for breast cancer, where as a solitary
intraductal papilloma carries little risk of developing subsequent breast cancer . The epithelial component
can be subject to a spectrum of morphologic changes ranging from metaplasia to hyperplasia, atypical
intraductal hyperplasia, and in situ carcinoma [2, 3].According to a consensus committee of the College of American Pathologists (4), women with solitary lesion have a 1.5- to 2-times relative risk of developing
invasive breast carcinoma in their lifetimes. Intraductal papilloma is a discrete benign tumour of the
epithelium of mammary ducts. It shows a predilection for the extreme ends of the ductal system the
lactiferous sinuses and the terminal ductules (7).

DISCUSSION
Surgical excision of this patient’s abnormal duct revealed the mass to be a solitary benign intraductal
papilloma(6).

The most common cause of spontaneous nipple discharge is a solitary central intraductal papilloma that
may cause a serous or bloody nipple discharge and is usually non palpable. The nipple orifice from which
the discharge arises subtends the involved duct (1,2). Althoght intraductal papillomas can present at any
age, solitary intraductal papillomas typically occur in perimenopausal women aged 35-55 years and are
usually less than 0,5 cm in diameter (3).

Solitary intraductal papillomas may be pathologically related to proliferative fibrocystic epithelial
hyperplasia. They are 2–3 mm and appear as broad-based or pedunculated polypoid epithelial lesions that
may obstruct and distend the involved duct. They may cause cysts by obstructing the duct.